The Access Core ofthe SPOTRIAS center at Partners will continue to support the rapid administration of standard intravenous thrombolysis, the rapid evaluation and treatment of hemorrhagic stroke, as well as the execution of the four proposed research projects (two independent Partners projects and two collaborative projects with Columbia University) at the two Partners academic centers. The Access Core will also strive to increase its impact on stroke in the broader community by extending its acute stroke expertise within and across our extensive network of Partners Healthcare System (PHS) and 26 TeleStroke-affiliated hospitals. This will help provide a platform from which to launch future SPOTRIAS network-wide stroke research. For the last two decades. Partners has enjoyed a rich clinical and research collaboration involving the Departments of Emergency Medicine, Radiology, Neurology, and Neurosurgery. The leadership of the Access Core reflects the integrated approach to acute stroke care across the system. The Access Core is co-directed by physicians from Neurology and Emergency Medicine who are institutional leaders in quality improvement, with additional key leadership positions held by active members of these departments at each site, all of whom care for acute stroke patients in their clinical practice. In addition, the two hospitals use the same acute stroke protocols, share the same acute stroke and NICU fellows and collaborate on the same acute stroke quality agenda. The Partners SPOTRIAS program is fully integrated into the daily activities of the clinical stroke care and stroke research activities at the two sites, and the Access Core is uniquely positioned to accomplish its goals because so many of the SPOTRIAS research faculties are also active members ofthe acute stroke clinical care delivery team. In pursuit of its aims, the Access Core will utilize the robust quality improvement infrastructure which Dr. Schwamm has developed across Partners for continued advancement of acute stroke care for patients within the broader context of a coordinated regional stroke network.